Provider Demographics
NPI:1679816664
Name:KEELER, JARIYA (RN,BC,CRNI,PCCN)
Entity Type:Individual
Prefix:
First Name:JARIYA
Middle Name:
Last Name:KEELER
Suffix:
Gender:F
Credentials:RN,BC,CRNI,PCCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 LEAHY ST APT 319
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94061-3978
Mailing Address - Country:US
Mailing Address - Phone:650-789-9086
Mailing Address - Fax:
Practice Address - Street 1:707 LEAHY STREET APARTMENTS #319
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94304
Practice Address - Country:US
Practice Address - Phone:650-780-9086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-28
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO112449282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital